HCS 487 Week 1 Technology Evaluation Chart Example

Ninety-Four Days for a Cardiology Visit: A Technology Evaluation Chart Comparing Four Ways a Community Health Center Network Could Speed Specialist Advice

[Student Name]

University of Phoenix

HCS/487: Technology and Systems Approach for Health Care Managers

Week 1 Assignment

[Instructor Name]

[Date]

The health center network, its wait times and its costs are composites written for a model paper; research findings come from the sources listed.

A composite network of 12 community health centers cares for roughly 61,000 people, the large majority on Medicaid or without insurance. Its primary care clinicians refer about 14,000 patients a year to specialists, but local specialists accept few Medicaid patients. The median wait for a new cardiology appointment is 94 days, for endocrinology 81 days and for dermatology 112 days. Only 48% of referrals end in a completed specialist visit within six months. The network's chief operating officer asked for an evaluation of technologies that might speed specialist advice. This paper presents that evaluation as a chart with supporting explanation.

The Criteria

Six criteria were applied to every technology. Effect on the problem: does it shorten time to specialist advice or raise completed referrals? Evidence: is there published research on its effect? Cost: license, implementation and ongoing costs. Integration: can it work within the network's electronic health record? Clinician burden: does it add work for primary care clinicians or specialists? Patient access: does it help patients with limited transportation, internet or English?

Technology One: Electronic Consultation

What it does: a primary care clinician sends a structured clinical question with relevant records to a specialist through a secure platform, and the specialist replies with advice, often within days, deciding whether a visit is needed. Effect: high. Evidence: strong. Liddy et al. (2016), in a systematic review of 36 studies, found e-consult systems widely adopted, with specialist response times from 4.6 hours to 3.9 days, many referrals avoided and generally positive experiences, though few studies reported clinical outcomes. Olayiwola et al. (2016), in a cluster-randomized trial in a network serving underserved patients, found 69% of cardiology e-consults resolved without a visit and a median of 5 days to specialist review compared with 24 days for usual referrals. Cost: moderate, including specialist payment per e-consult. Integration: good if the platform connects to the record. Clinician burden: some added documentation for primary care. Patient access: excellent, since patients need not travel.

Technology Two: Specialty Video Visits

What it does: patients see a specialist by video from a health center exam room or home. Effect: moderate; it removes travel but still requires specialist appointment time, which is the scarce resource. Evidence: moderate for convenience and satisfaction. Cost: moderate. Integration: fair. Clinician burden: low for primary care. Patient access: good from a health center room, weaker at home for patients without reliable internet.

Technology Three: Referral Tracking Module

What it does: an add-on to the electronic record that tracks each referral from order to completed visit and alerts staff when a referral stalls. Effect: moderate on completion, none on wait times. Evidence: limited published evidence, mainly quality improvement reports. Cost: low. Integration: excellent, since it is part of the existing record. Clinician burden: low; referral coordinators do the tracking. Patient access: neutral.

Technology Four: Online Self-Scheduling

What it does: lets patients book specialist appointments online once a referral is accepted. Effect: low on this problem, since the bottleneck is specialist availability, not booking. Evidence: moderate for reducing no-shows in some settings. Cost: low to moderate. Integration: depends on specialists' scheduling systems, which the network does not control. Patient access: helpful for some, a barrier for patients without internet.

The Chart in Summary

Rated from one to five on the six criteria, electronic consultation scored 26 of 30, referral tracking 20, video visits 19 and self-scheduling 13. The scarce resource is specialist time, so the best technology is the one that uses the least of it per patient question.

The Specialist Side

Any technology that depends on specialists must work for them too. The network's two partner specialty groups, a cardiology practice and an academic dermatology department, were asked what would make them willing to answer e-consults. Both wanted payment for each answered consult, a limit on response time expectations of three business days and structured questions that included the key test results, so they would not need to request missing information. The cardiology group added that it would reserve four new-patient slots a week for e-consult patients who still needed a visit, which would shorten waits for the patients most likely to need one.

Equity and Language

Most network patients prefer Spanish, Haitian Creole or Vietnamese, and many lack reliable home internet. Technologies that depend on patients' own devices or English-language interfaces would widen gaps. E-consults and referral tracking scored well here because they work between clinicians and staff, not through the patient's phone; video visits scored well only when held in a health center room with an interpreter.

User Acceptance

Davis (1989) proposed that people adopt a technology when they believe it will be useful and easy to use. The network surveyed 20 primary care clinicians: 17 said an e-consult tool would be useful, but 11 worried it would add documentation time. Ease of use therefore became a selection requirement.

Recommendation

The evaluation recommends electronic consultation combined with the referral tracking module. E-consults address the wait for specialist advice; tracking ensures that patients who still need a visit do not fall through the cracks. Video visits may be added later for specialties where e-consults resolve fewer questions, such as follow-up care for patients whose conditions need examination over time. Self-scheduling is not recommended at this time.

Limits of the Evaluation

Ratings rely partly on published studies from other settings and partly on judgment. Costs are estimates until vendors respond to a request for proposals, and the evidence for e-consults comes mostly from single specialties, so results may differ for endocrinology, where many questions involve medication adjustment over time.

Conclusion

Starting from the problem, long waits and incomplete referrals, the chart compared four technologies on the same six criteria. Electronic consultation, supported by a systematic review and a randomized trial in a similar population, scored highest, with referral tracking as a low-cost complement. Next week, the network will define its requirements and select a vendor.

References

Davis, F. D. (1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly, 13(3), 319-340. https://doi.org/10.2307/249008

Liddy, C., Drosinis, P., & Keely, E. (2016). Electronic consultation systems: Worldwide prevalence and their impact on patient care: A systematic review. Family Practice, 33(3), 274-285. https://doi.org/10.1093/fampra/cmw024

Olayiwola, J. N., Anderson, D., Jepeal, N., Aseltine, R., Pickett, C., Yan, J., & Zlateva, I. (2016). Electronic consultations to improve the primary care-specialty care interface for cardiology in the medically underserved: A cluster-randomized controlled trial. Annals of Family Medicine, 14(2), 133-140. https://doi.org/10.1370/afm.1869